National Nurses United

Localities all over the nation are also facing huge deficits and balancing their budgets by slashing public health services. That's the case in the Chicago area, where Cook County commissioners recently voted for crippling, 17 percent cuts to the county health system. (See companion story for more on Cook County.) Meanwhile, the unyielding forces of privatization keep pressuring public systems, whether it's in recent proposals to divert funding away from public health in order to help the uninsured buy private insurance, or to privatize traditional defined-benefit pensions for public workers into riskier 401(k) plans that private companies are eager to manage. Even public systems that are not losing money, such as California's state-run University of California system, are pleading poverty and applying these tactics as part of a larger trend in this direction. And as public health systems continue to lose money and worker compensation stagnates or worsens, the best, most experienced employees with other options leave—fueling what could be a death spiral for entire systems. It is in this context that, in February, more than 150 CNA/NNOC registered nurses and nurse practitioners working for publicly- owned healthcare systems gathered in San Jose, Calif. at a second annual conference to strategize about how to champion for their sector and patients against these assaults. Nurses from at least a dozen different public healthcare systems, from county hospitals and jails to healthcare district facilities to state-owned systems, shared stories about how they struggle to take care of the sickest patients with the most meager resources and budgets. "We have pregnant women walking the floors" because there are not enough beds available yet, reported John Schneider, an RN with Contra Costa Regional Medical Center, a county hospital in the northeastern San Francisco Bay Area that heavily serves the region's working class and immigrant populations. "Our ER sees 420,000 patients a year. The governor's plan [to divert public health money into buying private insurance] would literally kill us." Many nurses emphasized that their patients have no other options for accessing healthcare. In San Mateo County farther down the California coast, Jean Jacquemet, a public health nurse, said that without their public hospital, the county's poor, uninsured, indigent population would receive "little to no services," especially the population Fight Over Cook County Health B he man had been a patient of Kevin Barrett's for six years now. One afternoon this February, he showed up short of breath at the clinic where Barrett, a registered nurse with the Cook County Bureau of Health Services, treats HIV and AIDS patients. He moved things for a living, and now couldn't carry anything without getting winded. Barrett, who knew the man had other complicating conditions and was worried something was wrong with his lungs, would normally have immediately sent him upstairs to the clinic's radiology department for a chest x-ray. But the clinic had recently lost its radiology staff due to budget cuts. So Barrett stabilized his patient and sent him to the emergency room across the street at the bureau's main hospital, Stroger, to get an xray. The man, who spoke only Spanish, was told that the ER needed to order him an interpreter and to wait. So the man waited. And waited. And waited. He waited so many hours that his son came to drive away his car so it wouldn't get ticketed or towed. At 3 p.m. the next day, Barrett was surprised to see his patient again, still wheezing and still wearing the same clothes. The poor T 12 REGISTERED NURSE man had waited overnight in the ER but never been called or heard anything further. Frustrated, he gave up and left. Barrett told him it was important to get the x-ray and convinced him to return to the ER. "I felt so, so bad for him, but without our W W W. C A L N U R S E S . O R G radiology staff, there's nothing I can do," said Barrett, who is charge nurse of the bilingual clinic for the Bureau's CORE Center and the CNA/NNOC union steward there. "We used to be a one-stop shop. Now we have this radiology equipment and it's unused. For all we MARCH 2007

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